Healthcare Provider Details

I. General information

NPI: 1679864201
Provider Name (Legal Business Name): YOSEF Y WEXLER M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2011
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SMITH AVE N RITCHIE MEDICAL PLAZA SUITE 480
SAINT PAUL MN
55102-2393
US

IV. Provider business mailing address

310 SMITH AVE N RITCHIE MEDICAL PLAZA SUITE 480
SAINT PAUL MN
55102-2393
US

V. Phone/Fax

Practice location:
  • Phone: 651-220-6300
  • Fax:
Mailing address:
  • Phone: 651-220-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number57936
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: